Pilot evaluation of changes in motor control after wearable robotic resistance training in children with cerebral palsy

JOURNAL OF BIOMECHANICS

卷:126

Article

Conner, Benjamin C.¹  Schwartz, Michael H.^2,3  Lerner, Zachary F.^1,4 

[1] Univ Arizona, Coll Med Phoenix, Phoenix, AZ USA

[2] Gillette Childrens Specialty Healthcare, James R Gage Ctr Gait & Mot Anal, St Paul, MN USA

[3] Univ Minnesota, Dept Orthopaed Surg, Minneapolis, MN 55455 USA

[4] No Arizona Univ, Dept Mech Engn, 15600 S McConnell Drive,NAU EGR Bldg 69, Flagstaff, AZ 86011 USA

关键词: Cerebral palsy;    Neurorehabilitation;    Gait;    Exoskeleton;    Muscle synergy;   

DOI  :  10.1016/j.jbiomech.2021.110601

来源: Elsevier

【 摘 要 】

Cerebral palsy (CP) is characterized by deficits in motor function due to reduced neuromuscular control. We leveraged the guiding principles of motor learning theory to design a wearable robotic intervention intended to improve neuromuscular control of the ankle. The goal of this study was to determine the neuromuscular and biomechanical response to four weeks of exoskeleton ankle resistance therapy (exo-therapy) in children with CP. Five children with CP (12 - 17 years, GMFCS I - II, two diplegic and three hemiplegic, four males and one female) were recruited for ten 20-minute sessions of exo-therapy. Surface electromyography, three-dimensional kinematics, and metabolic data were collected at baseline and after training was complete. After completion of training and with no device on, participants walked with decreased co-contraction between the plantar flexors and dorsiflexors (-29 +/- 11%, p = 0.02), a more typical plantar flexor activation profile (33 +/- 13% stronger correlation to a typical soleus activation profile, p = 0.01), and increased neural control complexity (7 +/- 3%, p < 0.01 measured via muscle synergy analysis). These improvements in neuromuscular control led to a more mechanically efficient gait pattern (58 +/- 34%, p < 0.05) with a reduced metabolic cost of transport (-29 +/- 15%, p = 0.02). The findings from this study suggest that ankle exoskeleton resistance therapy shows promise for rapidly improving neuromuscular control for children with CP, and may serve as a meaningful rehabilitative complement to common surgical procedures.

【 授权许可】

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